P - 75496Minnesota Departrn t of Labor and Industry ��
443 Lafayette Roa . orth (�
St. Paul, MN 551 -4342 `�
Phone: (651) 2 064 n 1�
TTY/MRS: (65 97-4198 v
www.electricity ate.mn.us
Contra r Re uesi for Electrical I
Date Rough-In Inspeetion Required?
09/25/2008 Contractor Must Schedule All Rou I
Address of Inspection — Street
6800 7TH STREET NE
Owner Name
DENNIS JOHNSON
—:Include Area
/7R�1 �71 _tiQ�F',
Contractor Name
CENTERPOINT ENERGY
Contractor Telephone Number
(763) 757-6202
Authorized
tion — One Famil Dwellir
Yes Single Inspection Other Than
�ctions Contractor Must Schedule All
n:
City/Township County
FRIDLEY ANOKA
Project Description
WIRE/ RECONNECT AIR CONDITIONER
Structure
] Ready Now
� Will Schedule
Contractor Mailing Address
9320 EVERGREEN BLVD NW SUITE B COON RAPIDS, MN 55433
Contractor E-mail Address Electrical Utility
joann.zinken@CenterPointEnergy
Contractor License Number Job/Project Contact Person
CA01796 JOANN ZINKEN
Fee Calculation
Home or Associated Structure
New Dwelling Service/Power Sup 400 ampere @$35
New Dwelling Service/Power Supply 401 — 800 ampere @$60
Other
� to 30 FE
— More than 30
aeders/Circuits - $
�s (in addition to
200 A Ca� $6 Each
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New Feeders/Circuits ( ) @ $6 Each
Other (Specify)
(Specify)
Existing Home/Structure Remodel or Addition
New Service/Power Supply 0— 400 ampere @$35
New Service/Power Supply 401 — 800 ampere @$60
or16to30CaD$100
CCUGIa/\+IIl�Y1W — IYIVIG I IIUII JV � Gcucioiv�
Feeders/Circuits Up to 200 A@$6 Each
----
( 1 ) Feeders/Circuits @ $2 Each $2
Detached Garage or Other Associated Structure
New Service/Power Supply 0— 400 ampere @$35
New/Extended Feeders/Circuits ( ) @ $6 Each
Reconnected Feeders/Circuits ( ) @ $2 Each
Total (the fee calculated above nr $35 multiplied Tot81(the fee calculated above or $35 multiplied ���b
by the number of required inspection trips, by the number of required inspection trips, S.
whichever is greater) whichever is greater)
Requests for Electrlcal InspecUon,' (REq wlth a fee of $250 or less explre 12 months from the flling date. The contractor must have the work completed within
the 12 month perlod or submk another REI that Includes the lnspectlon fee for the uncompleted work. Inspectfon fees do not carry over from one REI to
another.
A servlce charge of $30 wlll be added for all dishonored checks.
I hereby certify that I inspected the electrical installation herein on the dates stated: For Department Use Only
Rough — In Inspection(s)
u
This materlal can be made
TDD (651) 297-4198.
REI 02 (6/0�
Date
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or on a tape. To request,
or